RESUMO
AIM: Concerns have been raised over patient outcomes following implantation of small aortic valves (size: 19 and 17â mm). However, in patients with a smaller body surface area, these valves may be adequate. The aim of th study was to assess the hemodynamic and functional performance of these valves and their impact on clinical outcomes in patients with a small aortic root. MATERIAL AND METHODS: This was a prospective observational study that included all consecutive patients undergoing aortic valve replacement (AVR) with a small-sized aortic valve over a 3-year period. Patients were followed up at 1 week, 6 weeks, and 1 year. Functional and clinical evaluation along with echocardiography was carried out for hemodynamic assessment. In-hospital mortality and hemodynamic outcomes at 1-year follow-up were recorded. RESULTS: Isolated AVR with a size 17â mm valve was carried out in 15 (25%) and with a 19â mm valve in 45 (75%) patients. The mean annular size was 19.12 ± 2.03â mm. The mean indexed effective orifice area was 1.08 ± 0.16â cm2/m2. Satisfactory decrease in peak and mean trans-prosthetic gradient were evident (peak gradient preoperatively was 92.15 ± 26.2â mmHg, and 25.68 ± 12.28â mmHg at 1 year, mean gradient was 55.31 ± 17.41â mmHg preoperatively and 13.71 ± 7.39â mmHg at 1 year). The functional status of patients also showed significant improvement post AVR. Left ventricular ejection fraction pre-operatively was 59.67% ± 10.38% and 59.57% ± 7.98% at 1-week, 59.15% ± 8.17% at 6 weeks, and 59.59% ± 7.48% at 1 year. CONCLUSION: When confronted with a small aortic root, AVR with a small-sized prosthesis provides a satisfactory hemodynamic and functional outcome. In patients with small body surface area, implantation of a small-sized valve is a viable option.